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Cerebrospinal Fluid

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Optimized System for Cerebral Perfusion Monitoring in the Rat Stroke Model of Intraluminal Middle Cerebral Artery Occlusion

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Cooling for cerebral protection during brain surgery.

Wilson Roberto Oliveira Milani¹, Pedro L Antibas, Gilmar F Prado

¹Department of Anaesthesiology, Hospital Sírio Libanês, São Paulo Serviços Médicos de Anestesia, Rua Barão de Jaceguai,1062 ap. 91, São Paulo, São Paulo, Brazil, CEP: 04606-002.

The Cochrane Database of Systematic Reviews

|October 7, 2011

Summary

Induced hypothermia (controlled lowering of body temperature) is used during brain surgery to prevent ischaemic injury. However, current evidence does not confirm its effectiveness or safety compared to maintaining normal temperature.

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Area of Science:

Neurosurgery
Anesthesiology
Critical Care Medicine

Background:

Brain surgery poses a risk of ischaemic injury, potentially leading to severe complications.
Induced hypothermia, a method of lowering body temperature, is employed during neurosurgery to mitigate this risk.
Despite its use, the clinical effectiveness of hypothermia for neuroprotection during brain surgery remains unestablished.

Purpose of the Study:

To evaluate the effectiveness and safety of induced hypothermia versus normothermia for neuroprotection in patients undergoing brain surgery.

Main Methods:

A systematic review was conducted, searching multiple databases including CENTRAL, MEDLINE, LILACS, and EMBASE up to November 2010.
Included were randomized and quasi-randomized controlled trials comparing induced hypothermia with normothermia for neuroprotection during brain surgery.
Data were independently assessed and extracted by two authors, with additional information sought from study authors.

Main Results:

Four trials involving 1219 patients were included in the analysis.
No evidence was found to support the effectiveness or ineffectiveness of hypothermia for neuroprotection during brain surgery when compared to normothermia.
Similarly, no evidence indicated that hypothermia was unsafe in this context.

Conclusions:

While mild hypothermia appears safe, its effectiveness for cerebral protection during brain surgery compared to normothermia is unclear.
Further clinical trials are necessary to definitively establish the benefits of hypothermia before routine use can be recommended.
The current evidence does not support the routine application of induced hypothermia for neuroprotection in brain surgery.